Shape the Community’s Future
Join Your Local Chamber!

Your Financial Investment in the West Branch Area Chamber of Commerce is an Investment in Your Own Business. At the Chamber, We Don’t Just Talk About the Future, We Shape it. Together we can Blend Our Talents to Insure a Better Community for All.

APPLICATION:

Date:

Name of Business:

       Main Contact or Person to the Chamber: 

Street Address:

P.O. Box:

 City:

Zip:

Billing Address:

P.O. Box:

 City:

Zip:

Phone:

            Fax:

Website:

Email Address:

Type of Business:

Specific Products or Services:

Number of Employees:            Full Time:            Part Time:

Please indicate the preferred method of communication:  Email:   Fax:   Mail:

ADDITIONAL CONTACT INFORMATION:

Additional Contacts:

Do You Participate in the Chamber Blue Cross Program?     Yes     No

Main Reason(s) for Joining:  Networking: Marketing:   Business Resource:   Advocacy:   Legislative:   Economic Development:   Website:   Referrals:   Directory Listing:   Insurance:   Benefits:   Community Involvement: Committee Participation:   Other:

If “other” please list:

Would you like to volunteer on a Chamber Committee?  Yes:   No:

Who may we thank for referring you?